November 2022

Cocoa Confusion

As the holiday season approaches, many of us eat a little more chocolate than normal. Some might try to justify it as a healthy treat. While it’s true that cocoa flavanols might improve heart health, make sure patients understand this doesn’t mean they should be loading up on sugary milk chocolate.

To understand the benefits of chocolate, it’s important to understand the distinction between “cocoa” and “chocolate.” Cocoa beans are the seeds of the cocoa tree. Pressing roasted cocoa beans between hot rollers makes bitter chocolate. Squeezing the fat (cocoa butter) from bitter chocolate makes cocoa powder. Sweet chocolate, either dark or milk, is made by adding varying amounts of sugar to bitter chocolate. Milk chocolate also includes some form of milk, and therefore much less cocoa. While the end-result is delicious, it’s the cocoa bean powder, not the added milk and sugar, that contains antioxidants called flavonols, including epicatechin and catechin. These are the compounds that are responsible for the heart health benefits associated with chocolate.

Explain to patients that not all chocolates are equal. While the color of the chocolate and the percentage of cocoa present won’t give you exact details on flavanol content, it can help to identify healthier options. The percentage on a chocolate bar simply tells you how much sugar has been added. For example, a 70% cocoa bar contains 70% cocoa and 30% sugar. The higher the cocoa percentage the better – more cocoa means more flavanols. But tell patients not to go overboard – population research shows that consuming more than 90 grams of cocoa per week doesn’t seem to offer additional benefits.

Check out our recently updated monograph to learn more.

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